Cognitive rehab & memory enhancement: evidence-based interventions (Part 3)

Cognitive rehab & memory enhancement: evidence-based interventions (Part 3)

Physical exercise

Another powerful predictor of cognitive ability in middle age and older adulthood is physical exercise. We have a fairly good understanding of how physical exercise affects cognition, including which types of cognitive abilities are improved, what type of physical exercise leads to cognitive improvements, and even how much physical exercise is necessary to see improvement.


Researchers from Rush University recently reported results of a study where they followed older adults, average age 82 years, for 3.5 years and measured their activity levels using an actigraph, a device that monitored activity levels on participants’ nondominant wrists. The people who moved the least (bottom10%) were 280% more likely to develop dementia during the course of the study than those who moved the most (top 10%). 11 In another study published in the Journal of the American Medical Association, researchers found that older adults, average age 77 years, who exercised the most (top 33%) were 61% less likely to get dementia compared to those who exercised the least (bottom 33%). 12That is a remarkable finding, especially considering it doesn’t take that much exercise to get into the top 33%.


What type of exercise is best? We know that aerobic exercise such as walking leads to improvements in attention, which leads to improvements in a whole host of cognitive and memory tasks. 13 Older adults can get an additional benefit if they lift some light weights or do strength training. In one study, researchers had adults ages 65–75 years do strength training once or twice a week for one year. They found that the once-a-week group had an 11% improvement in attention and concentration, while the twice-a-week group had a 13% improvement.14  In a separate study, researchers found that people with mild cognitive impairment (a memory disorder that is not severe enough to be diagnosed as dementia) also had significant improvements in cognition when they began a light strength-training program. 


Any increase in physical activity has the real possibility of leading to improvements in cognition and other aspects of health. Here are some ways people can increase overall physical activity levels:

  • Take the stairs instead of the elevator.

  • Go for a 30-minute walk in the evening.

  • Plant and tend a garden.

  • Walk or ride a bicycle to run errands, if possible.

  • Join a gym.

  • Swim.

  • Exercise with a friend or spouse.


Also, the National Institute on Aging, one of the National Institutes of Health in the United States, offers a variety of resources on physical activity and exercise for older adults (some of the institute’s resources appear in the sidebar on this page). These resources provide information and guidance for becoming physically active.


Who benefits the most from physical exercise? It appears that the older someone is, the more exercise helps.13 One intriguing finding is that women benefit more from physical exercise than men 13, although we don’t know exactly why. While there is evidence that women’s bodies respond differently to physical exercise, it might also be that women are more likely to exercise with other people, which would give them a simultaneous social-brain exercise as well.


The fact is most older adults would benefit from physical exercise. In addition to improving attention and concentration, exercise can improve mood, reduce the chance of developing diabetes, improve sleep quality, and decrease the chance of a heart attack or stroke. All of these improvements to health have been associated with either improved memory or a decreased chance of developing dementia.



Other ways to maximize memory ability are to improve nutrition, decrease obesity and avoid diabetes. Fish is a good source of omega-3 fatty acids, for example. Already associated with heart 16 health, these essential fats appear to be good for the brain. Research has shown that older adults who eat more fish (or take a fish oil supplement) are less likely to develop dementia. In one major study, researchers studied 15,000 people in Latin America and Asia and found that those who ate fish nearly every day were 20% less likely to get dementia compared to those who ate it only a few times a week. Further, those who ate fish a few times per week were 20% less likely to get dementia than those who rarely ate fish.


According to a study published in 2011 in the journal Neurology, obesity is associated with a 288% increase in the likelihood of developing dementia, while being merely overweight is associated with a 71% 18 increased risk. Another concern is that obesity is a risk factor for type 2 diabetes. Even prediabetes, a condition in which blood glucose levels are higher than normal, impairs the ability of older adults to concentrate and pay attention, which can dramatically worsen their memory ability and ability to care for themselves. Now a new European study suggests that both excess weight and diabetes in midlife (ages 39–63 years) are independently associated with a significant impact on cognition as people age. Further, obesity is linked to a faster rate of cognitive decline, most especially when metabolic conditions such as diabetes are present.


Obviously, what we eat and what we weigh will affect quality of life and longevity in later life. It is also increasingly apparent that these things will affect our minds. Active-aging professionals can support older adults’ cognitive health by developing programs on healthy eating and sharing resources with these individuals (such as the National Institute on Aging resources listed on page 28).


This article is provided courtesy of the International Council on Active Aging